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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00042770
Other study ID # CALGB-30102
Secondary ID U10CA076001CALGB
Status Completed
Phase Phase 3
First received August 5, 2002
Last updated July 1, 2016
Start date May 2002
Est. completion date February 2008

Study information

Verified date July 2016
Source Alliance for Clinical Trials in Oncology
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Interventional

Clinical Trial Summary

RATIONALE: It is not yet known whether pleurodesis using a chest tube with infusions of talc is more effective in improving quality of life than pleurodesis using a small catheter in treating malignant pleural effusion.

PURPOSE: Randomized phase III trial to compare the effectiveness of a chest tube and talc with that of a small catheter in treating malignant pleural effusion in patients who have cancer.


Description:

OBJECTIVES:

- Compare the success rate in patients with cancer who undergo pleurodesis using a standard chest tube with talc slurry vs a small (PleurX) catheter for the treatment of a symptomatic unilateral malignant pleural effusion.

- Compare the 30-day effusion control rate in patients treated with these procedures.

- Compare quality of life in these patients at 7-14 and 30-37 days after treatment with these procedures.

- Compare patient acceptance and satisfaction after treatment with these procedures.

- Compare the level of symptoms and dyspnea experienced by patients treated with these procedures.

- Compare the types, causes, and rates of early technical failures of these procedures in these patients.

- Compare the 30-day effusion recurrences in patients treated with these procedures.

- Compare the 60-day durability of pleurodesis in patients treated with these procedures.

- Compare the mortality, morbidity, and common surgical complications in patients treated with these procedures.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to inpatient status (yes vs no), disease type (breast vs lung vs other), and concurrent systemic chemotherapy (yes vs no). Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients undergo placement of a standard pleural chest tube. Within 36 hours of chest tube placement, patients undergo pleurodesis comprising intrapleural administration of talc slurry once followed by clamping of the chest tube for 2 hours while different patient positions are used to distribute the talc. The chest tube is then unclamped to allow continuous drainage. When the chest tube drainage is less than 150 mL over 24 hours, pleurodesis is assumed and the chest tube is removed.

- Arm II: Patients undergo pleurodesis comprising placement of a small (PleurX) catheter followed by pleural drainage for up to 90 minutes once daily. When the catheter drainage is less than 30 mL per day for 3 consecutive days, pleurodesis is assumed and the catheter is removed.

Quality of life and dyspnea are assessed at baseline and then at 7-14 and 30-37 days after treatment.

Patients are followed at 30 and 60 days.


Recruitment information / eligibility

Status Completed
Enrollment 67
Est. completion date February 2008
Est. primary completion date February 2005
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility DISEASE CHARACTERISTICS:

- Radiologic evidence of a unilateral malignant pleural effusion requiring sclerosis or ongoing drainage because it is symptomatic (dyspnea and/or progressive fatigue)

- An asymptomatic patient is eligible if the patient underwent a prior thoracentesis within the past 2 weeks and was symptomatic before the procedure

- No bilateral effusions by plain chest x-ray

- Histologically or cytologically confirmed solid tumor or hematologic malignancy

- Histologic confirmation of malignant cells in pleural fluid is not required

- Pleural spaces must be naive to pleurodesis attempts

- No prior intrapleural therapy (defined as a chest tube in place or placed to drain an effusion, prior surgical pleurectomy, or any prior chemical or mechanical pleurodesis on the ipsilateral side)

- Placement of a small interventional radiology catheter for temporary drainage is not considered intrapleural therapy as long as no sclerosant medication was given and it has not been in place longer than 10 days

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- CTC 0-2

Hematopoietic

- Granulocyte count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

Pulmonary

- No active pleural infection

Other

- No allergy to talc

- No surgical contraindication to talc usage

- Not pregnant or nursing

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Chemotherapy

- Concurrent systemic chemotherapy allowed

Radiotherapy

- Concurrent palliative radiotherapy to a symptomatic lesion allowed except to the treated hemithorax within 30 days of the drainage procedure

Surgery

- See Disease Characteristics

- Prior thoracotomies without specific pleural ablation (including lobectomy but not pneumonectomy) allowed

- Prior needle-based diagnostic interventions (fine-needle aspiration, small bore catheter drainage of less than 10 days, or thoracentesis) allowed

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment


Intervention

Other:
talc
Given intrapleurally
Procedure:
dyspnea management
No talc

Locations

Country Name City State
United States Providence Saint Joseph Medical Center - Burbank Burbank California

Sponsors (2)

Lead Sponsor Collaborator
Alliance for Clinical Trials in Oncology National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Effusion control 30 days No
Secondary Quality of Life 7-14 days and 30-37 days No
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